Antibiotics and Acne Treatment
Acne is the most common skin condition in the United States, with about 40 to 50 million people affected by it, primarily teenagers and young adults, according to the American Academy of Dermatology. Although acne is not curable, symptoms of mild to moderate acne can usually be controlled with treatment. Acne therapy may include antibiotics.
Acne usually begins with an increase in the production of skin oil, or sebum, which occurs during adolescence due to hormonal activity. Excess oil clogs pores, and anaerobic acne-causing bacteria, called Propionibacterium acnes, flourish in this environment, multiplying and causing inflammation. When the flow of oil is blocked near the skin's surface, it causes a blackhead or whitehead, and if it occurs deeper, a pus-filled pimple develops, typically causing mild to moderate inflammation. Very deep cysts and nodules cause pain and intense inflammation.
Both topical and oral medications, including antibiotics, are available for treating acne, notes the AAD. Some patients use both. Aside from spot treatment, results are usually noticeable within four to eight weeks, as acne treatment focuses primarily on preventing new breakouts. Ongoing treatment is necessary because acne therapy cannot cure the condition. It can take years before the skin disorder eventually resolves on its own.
Topical and oral antibiotics inhibit the growth and multiplication of P. acnes, and this decreases inflammation. Topical antibiotics are most effective for people with mild to moderate inflammatory acne. Oral antibiotics are the standard line of therapy for moderate to severe acne, acne that affects large areas of the body and acne that does not respond to topical therapy, according to the AAD. Treatment with oral antibiotics usually lasts six months or less, but patients can use topical preparations longer.
Topical antibiotics useful for treating acne include clindamycin and erythromycin, which decrease populations of P. acnes and decrease inflammation, notes the AAD. These are sometimes combined with benzoyl peroxide for more effective results. Benzoyl peroxide, azelaic acid and sodium sulfacetamide are common topical therapies for acne. Although they kill or inhibit the growth of P. acnes bacteria, they are classified as antimicrobials rather than antibiotics.
Erythromycin, tetracycline and the tetracycline derivatives doxycycline and minocycline are the oral antibiotics most often prescribed to treat acne. Doctors generally only prescribe erythromycin and minocycline if other therapies do not work or the patient cannot tolerate them. P. acnes resistance to erythromycin is increasing, and minocycline causes some rare but serious side effects not usually associated with the other antibiotics, according to an article published in the May 1, 2004 issue of "American Family Physician."
All the oral antibiotics prescribed for acne can cause digestive side effects such as loss of appetite, nausea and diarrhea, according to the "American Family Physician" article. The tetracycline antibiotics tend to cause increased sensitivity to ultraviolet light. Minocycline has rarely been linked to hypersensitivity reactions, skin and mucous membrane discoloration, and the development of a lupus-like syndrome.
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